If you’ve watched Grey’s Anatomy, then you’ve gotten a peek into the complex hierarchies that rule a hospital. Over 17 seasons, the show’s eponymous heroine, Meredith Grey, ascends from a lowly intern to chief of general surgery, learning from the presiding residents and older surgeons along the way. There’s rarely doubt about who is in charge, who has more expertise, or who should be supervising and training other staff.

Grey’s fictional journey illustrates the complicated dynamics of a healthcare setting, whether it’s a local clinic or a bustling city hospital. Doctors, nurses, other clinicians, and administrators are part of a system where tenure, expertise, and training dictate the chain of command. Those hierarchies can help teams provide care efficiently, but what happens when those traditional roles are disrupted?

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